TIPS FOR COMPLETING THE DS-7002(TRAINING/INTERNSHIP PLACEMENT PLAN)

AJ-1Student-Intern is required topresent aTraining/Internship Placement Plan,known as theForm DS-7002,when applying foraJ-1visa at aU.S. embassy or consulate . The DS-7002 outlines the proposed internship . It demonstrates that the Student -Intern and the hostingMidwest University have agreed on the educational research objectives that will be reached during the internship program . It also explainshow the Student-Intern will be supervised throughout the internship. This guide will assist you in completing the DS-7002.

SECTION 1: PARTICIPANT INFORMATION(COMPLETED BY Midwest University ADMINISTRATOR)

• Trainee/Intern Name: Must match name on Student-Intern’s passport exactly

• E-mail Address: Provide the student-intern’s e-mail address

• Program Sponsor: Midwest University

• Program Category: Student-Intern

• Occupational Category: Student

• Current Field of Study or Profession: Student-Intern’s current academic field of study (i.e. major) at his or her home institution

. • Experience in the Field: N/A

• Type of Degree or Certificate: Student-Intern’s current level of study at his or her home university, for example: Bachelor’s; Master’s; PhD; MD; etc. The student must be currently enrolled in this program.

• Date Awarded or Expected: Date on which the student is EXPECTED to complete his/her current program of study.

• Training/Internship Dates: Start and end dates of the MIRI internship, up to 12 months. Note that the J regulations do notpermit any extensions of the Student-Intern program beyond 12 months.

SECTION 2: COMPENSATION(COMPLETED BY Midwest University ADMINISTRATOR)

• Organization Name

• Street Address or Training/Internship Site: Complete address and building name where the internship will take place

• Website: Eebsite for the department hosting the Student-Intern

• Employer ID Number (EIN)

• Exchange Visitor Hours per Week: Minimum of 32 hours per week.

• Compensation:

- Stipend: Yes or No if your MIRI will give the Student-Intern funds.

- If Yes, how much? Amount and frequency of stipend, e.g. $500 per month, $15 per hour, etc.

- Non-Monetary Compensation Value: If your MRI will pay for housing, food, flight(s), conference fees, seminar fees, etc.,add the total and enter the amount here.

• Worker’s Compensation (WC) policy?

• Does your WC Policy cover the exchange visitors? Information to come from Sarah G

• Number of Full Time Employees

• Annual Revenue

SECTION 3: CERTIFICATIONS(SIGNED BY STUDENT-INTERN AND MIO ADVISOR)

• Skip this section until Section 4 is complete.

• Trainee/Intern will sign and date on page 1. Scanned copies are acceptable.

• Sponsor (page 2): MIRI J-1 Advisor will sign and date. Leave blank for MIRI advisor to complete.

Midwest International Research Institute | 851 Parr Rd. Wentzville, MO 63385 U.S.A

(636) 327-4645 | miri@midwest.edu | www.midwest.edu

SECTION 4: TRAINING/INTERNSHIP PLACEMENT PLAN (COMPLETED BY DEPARTMENT ADMINISTRATOR)

• Surname/Primary, Given Name:Student-Internname(mustmatchpassportexactly)

• The Exchange Visitor Is: Student-Intern

• Program Sponsor: Midwest University

• Program Number: P-1-00045

• Main Program Supervisor/POC at Host Organization: Name of Supervisor or PI

• Title: Supervisor’s Title

• Supervisor Contact Information: Phone, Fax, Email

SECTION 4: PHASE INFORMATION

• Phase Site Name:List

name

ofspecific

lab

oracademic

department

• Training/Internship Field:Specific

field

ofinternship

such

asengineering,

physics,

law,

etc.

• Phase Site Address: Street Address of primary site of activity

• Phase Name:

- If the internship only has one phase, you can list Student-Internship. - If the internship has multiple phases,

name

each

phase

accordingly

(such

asobservation

phase,

lab

work

phase,

etc.

In

addition, you will need to complete a separate page 3 for the DS-7002 for each individual phase.

• Start Date of Phase and End Date of Phase:List

the

start

and

end

ofthe

specific

phase.

• Phase _ of __: You can list 1 of 1 if there is only one internship phase.

• Primary Phase Supervisor:Who

will

bethe

main

supervisor

forthe

Student-Intern

(during

this

phase)?

Ifthere

will

beco-supervisors,

enter the information for the supervisor who will have the most contact with the Student-Intern.

• Description of Trainee/Intern’s Role:Brief,

1-2

sentence

description

stating

specifically

how

the

internship

will

complement

the

Student-Intern’s academic program at his or her home institution. - Example 1: The Student-Intern will be in charge of supporting technical work related to the regulation of adult stem cell activity

in multiple mammalian tissues. - Example 2: The Student-Intern will be responsible for the development of a scientific manuscript in the field of reproductive

medicine and nutrition that could be submitted for publication to a peer-reviewed medical journal. - Example 3: The Student-Intern will take part in the daily work at <name of lab/department>. He will perform supervised and non-

supervised cell-sorts, sorting up to 8-colors of cell staining and analysis. He will perform short-term supervised research projects. • Specific

Goals

and

Objectives

for

this

Phase: This section must illustrate what will be learned by the Student-Intern. What must

happeninorder

forthis

phase

tobecompleted?

What

must

happen

before

the

Student-Intern

can

move

ontothe

next

phase,

if

applicable?Apublication

orathesis

can

beanobjective.

- Example 1: The objective of this internship is to provide the Student-Intern with research experience that will be used to complete

the requirements for his Master’s degree in Molecular Bioscience at University. We will train him in multiple techniques relevant to cell biology , molecular genetics and biochemistry . By the end of his training , he should be familiar with interpreting data from

multiple experiments and developing hypotheses for further testing. - Example 2: Specific tasks will include statistical data analysis, literature reviews, manuscript drafting and revision. Emphasis

will be placed on data analysis. The Student-Intern will learn how to write a scientific report for publication in a peer reviewed medical journal and will acquire: User-level knowledge of epidemiologic study design; Basic user-level knowledge of statistical techniques for the analysis of medical data; User-level knowledge of implementation of epidemiologic and statistical concepts of reproductive medicine and nutrition problems

- Example 3: To be able to run and troubleshoot special order instruments; Learn how to design and to perform up to 8 colors multi-color cytometry staining and analysis; Run cell sorting under different pressure conditions and interchangeable nozzles; Become familiar with: 96 well plate sorting; Slide Cell sorting; Micro- and nanoparticiples sorting.

Midwest International Research Institute | 851 Parr Rd. Wentzville, MO 63385 U.S.A

(636) 327-4645 | miri@midwest.edu | www.midwest.edu

(COMPLETED BY Midwest University ADMINISTRATOR)

• Names and title of those who will provide daily supervision:Whatarethesepersons’qualificationstoteachtheplannedlearning?Each person who will have supervisory responsibilities must be listed here.

- Name,Title,Qualifications(e.g.Ph.D.inEpidemiology.Co-authorof10peer-reviewedpublicationsinmedicaljournals)

- Example: Professor X has been a Faculty Member for 5 years, and he currently supervises a research team consisting of 10 postdoctoral fellows and 3 Research Associates.

• What plans are in place for the trainee/intern to participate in cultural activities while in the United States?

American cultural activities are a requirement of the J-1 Student-Intern regulations. The expectation is that, as the host department, youwillprovidetheStudent-Internwithplanned,intentionalAmericanculturalexperiences.ItisnotsufficientfortheStudent-Internto simply have incidental contact with American students or researchers at an American university.

- Examples: The Student-Intern will be invited to attend conferences/lectures in the X department; participate in department happy hours or socials (only if the student is over the age of 21); attend dinner at supervisor’s home; attend concerts or film festivals; attend specific Midwest-sponsored events; attend sporting events; museum visits; holiday parties; BBQ/picnic; or visiting local cultural festivals.

• Whatspecificknowledge,skills,ortechniqueswillbelearned?TheresponseshouldexpandontheGoalsandObjectives.Itshould provide substantial details regarding what the Student-Intern is going to learn by the end of the internship.

- Example: The Student-Intern will become familiar with FACS analysis, mammalian cell culture techniques, Cas9-mediated mutations, transgenic animal generation and western blots.

• How,specifically,willtheseknowledge,skillsortechniquesbetaught?Includespecifictasksandactivities.

- Example 1: The Student-Intern will be closely monitored by a postdoctoral fellow in Professor X’s laboratory. He will begin by learning and observing techniques; practicing one or two at a time and becoming proficient before adding more, and ultimately will be expected to become independent and proficient such that he can complete these lab techniques himself. There will be weekly lab team meetings with opportunities for questions and discussion.

- Example 2: The Student-Intern will join a week-long training provided by X lab to become an auditor in introductory-level epidemiology and biostatistics courses offered to graduate students. The Student-Intern will also participate in a bi-weekly seminar at the Nutrition and Epidemiology departments. The Student-Intern will participate in the weekly and monthly meetings of Dr. X’s lab research groups, at which research projects for students and post-docs are discussed.

- Example 3: The Student-Intern will attend lectures on instrumentation and cytometry. He will assist with the calibration of equipment and fluorescent protein-based cell sorting. He will assist with multi-color cell analysis; DNA and cell analysis; and imaging cytometry analysis. He is expected to become familiar with FACS data standards, and batching analysis. We fully expect him to develop expertise through specific short-term research projects.

• HowwilltheTraineeorIntern’sacquisitionofnewskillsandcompetenciesbemeasured?

This section must describe how the faculty supervisor is evaluating the performance of the Student-Intern in light of the goals and objectives described in the training plan.

The faculty supervisor is required to complete a written evaluation of the Student-Intern if the internship lasts 6 months or less, and two written evaluations if the internship is longer than 6 months. Evaluations must be in writing and provided at the conclusion of a phase and/or the Internship.

• MIRI has sample Evaluation forms (Mid-point and Final) that you may use if needed. - Example 1: The Student-Intern’s performance will be evaluated weekly by Professor X, and daily by graduate students and

postdoctoral fellows working with the Student-Intern. The Student-Intern’s acquisition of new skills will be measured by the research results and conclusions he draws; this will be documented as part of a final, written report that will be submitted to his dissertation advisor at University.

- Example 2: Performance will be evaluated by the achievement of specific tasks necessary to produce a high-quality scientific manuscript. This includes evaluation of progress with analyses; generation of tables and figures; and generation of manuscript drafts. Depending on performance, the Student-Intern may also be encouraged to produce abstracts for scientific meetings based on his work. His work will be measured on a daily basis using a scale from 1 to 5. This daily evaluation will be sent to his home university and provided to him directly upon completion of the internship.

• Additional Phase Remarks: You may add anything you believe is important. This section is optional.

• Phase Supervisor:SignatureofSupervisor(page4):SupervisormustsignbeforesubmittingrecordtoMIRI. Scanned copies

are

acceptable.

Midwest International Research Institute | 851 Parr Rd. Wentzville, MO 63385 U.S.A

(636) 327-4645 | miri@midwest.edu | www.midwest.edu